Hypercalcemia and Malignancy: Mechanism

Hypercalcemia affects up to a third of cancer patients and malignant hypercalcemia is the most common oncological emergency leading to hospitalization.

Most likely to occur in: breast cancer, multiple myeloma and lung cancer. However, it can also be found in other malignancies, including: gynecologic, renal and head & neck cancers

CAUSE: Increased osteoclastic bone resorption.

• Solid tumours can produce parathyroid hormone–related protein (PTHrP), increasing calcium levels in the blood by activating parathyroid hormone receptors in tissue, which results in osteoclastic bone resorption; it also increases renal tubular resorption of calcium.

REFERENCES

1. Bower M, Cox S. Endocrine and metabolic complications of advanced cancer. In: Doyle D, Hanks G, Cherny NI, Calman K, editors. Oxford textbook of palliative medicine. 3rd ed. New York, NY: Oxford University Press; 2004. pp. 688–90.
2. Lumachi F, Brunello A, Roma A, Basso U. Cancer-induced hypercalcemia. Anticancer Res. 2009;29(5):1551–5.
3. Seccareccia D. Cancer-related hypercalcemia. Canadian Family Physician. 2010;56(3):244-246.